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Effects of gesture+verbal treatment for noun and verb retrieval in aphasia



Links between verbs and gesture knowledge suggest that verb retrieval may be particularly amenable to gesture+verbal training (GVT) in aphasia compared to noun retrieval. This study examines effects of GVT for noun and verb retrieval in nine individuals with aphasia subsequent to left hemisphere stroke. Participants presented an array of noun and verb retrieval deficits, including impairments of semantic and/or phonologic processing. In a single-participant experimental design, we investigated effects of GVT for noun and verb retrieval in two counterbalanced treatment phases. Effects were evaluated in spoken naming and gesture production to pictured objects and actions. Spoken naming improvements associated with large effect sizes were noted for trained nouns (5/9) and verbs (5/9); no improvements were evident for untrained words. Gesture production improved for trained nouns (8/9) and verbs (6/9), and for untrained nouns (2/9) and verbs (2/9). No significant differences were evident between nouns and verbs in spoken naming or gesture production. Improvements were evident across individuals with varied sources of word retrieval impairments. GVT has the potential to improve communication by increasing spoken word retrieval of trained nouns and verbs and by promoting use of gesture as a means to communicate when word retrieval fails. (JINS, 2006, 12, 867–882.)


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Correspondence and reprint requests to: Dr. Anastasia Raymer, Department of ESSE, 110 Child Study Center, Old Dominion University, Norfolk, VA 23529-0136. E-mail:


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Arbib, M.A. (2005). From monkey-like action recognition to human language: An evolutionary framework for neurolinguistics. Behavioral and Brain Sciences, 28, 105167.
Berndt, R.S., Mitchum, C.C., Haendiges, A.N., & Sandson, J. (1997). Verb retrieval in aphasia. 1. Characterizing single word impairments. Brain and Language, 56, 68106.
Busk, P.L. & Serlin, R.C. (1992). Meta-analysis for single-case research. In T.R. Kratochwill & J.R. Levin (Eds.), Single-case research design and analysis (pp. 187212). Hillsdale, NJ: Erlbaum.
Cappa, S.F. & Perani, D. (2003). The neural correlates of noun and verb processing. Journal of Neurolinguistics, 16, 183189.
Caramazza, A. & Hillis, A.E. (1991). Lexical organisation of nouns and verbs in the brain. Nature, 349, 788790.
Conlon, C. & McNeil, M. (1991). The efficacy of treatment for two globally aphasic adults using visual action therapy. In T. Prescott (Ed.), Clinical aphasiology, Vol. 19 (pp. 185194). Austin, TX: Pro-Ed.
Damasio, H., Grabowski, T.J., Tranel, D., Ponto, L.L.B., Hichwa, R.D., & Damasio, A.R. (2001). Neural correlates of naming actions and of naming spatial relations. NeuroImage, 13, 10531064.
Damasio, A.R. & Tranel, D. (1993). Nouns and verbs are retrieved with differently distributed neural systems. Proceedings of the National Academy of Sciences of the United States of America, 90, 49574960.
Decety, J., Grezes, J., Costes, N., Perani, D., Jeannerod, M., Procyk, E., Grassi, F., & Fazio, F. (1997). Brain activity during observation of actions: Influence of action content and subject's strategy. Brain, 120, 17631777.
Druks, J. (2002). Verbs and nouns—A review of the literature. Journal of Neurolinguistics, 15, 289315.
Fridman, E.A., Immisch, I., Hanakawa, T., Bohlhalter, S., Waldvogel, D., Kansaku, K., Wheaton, L., Wu, T., & Hallett, M. (2006). The role of the dorsal stream for gesture production. NeuroImage, 29, 417428.
Gallagher, H.L. & Frith, C.D. (2004). Dissociable neural pathways for the perception and recognition of expressive and instrumental gestures. Neuropsychologia, 42, 17251736.
Hamzei, F., Rijntjes, M., Dettmers, C., Glauche, V., Weiller, C., & Buchel, C. (2003). The human action recognition system and its relationship to Broca's area: An fMRI study. Neuroimage, 19, 637644.
Helm-Estabrooks, N., Connor, L.T., & Albert, M.L. (2000). Treating attention to improve auditory comprehension in aphasia. Brain and Language, 74, 469472.
Hoodin, R.B. & Thompson, C.K. (1983). Facilitation of verbal labeling in adult aphasia by gestural, verbal or verbal plus gestural training. In R.H. Brookshire (Ed.), Clinical Aphasiology, Vol. 13 (pp. 6264). Minneapolis: BRK Publishers.
Kable, J.W., Kan, I.P., Wilson, A., Thompson-Schill, S.L., & Chatterjee, A. (2005). Conceptual representations of action in the lateral temporal cortex. Journal of Cognitive Neuroscience, 17, 18551870.
Kable, J.W., Lease-Spellmeyer, J., & Chatterjee, A. (2002). Neural substrates of action event knowledge. Journal of Cognitive Neuroscience, 14, 795805.
Kaplan, E., Goodglass, H., & Weintraub, S. (2001). Boston Naming Test. Philadelphia, PA: Lea and Febiger.
Kertesz, A. (1982). Western Aphasia Battery. San Antonio, TX: Psychological Corporation.
Lambon Ralph, M.A., Moriarty, L., & Sage, K. (2002). Anomia is simply a reflection of semantic and phonological impairments: Evidence from a case-series study. Aphasiology, 16, 5682.
Luria, A. (1970). Traumatic aphasia. The Hague: Mouton.
Martin, A., Haxby, J.V., Lalonde, F.M., Wiggs, C.L., & Ungerleider, L.G. (1995). Discrete cortical regions associated with knowledge of color and knowledge of action. Science, 270, 102105.
Miceli, G., Silveri, C., Villa, G., & Caramazza, A. (1984). On the basis for agrammatics' difficulty in producing main verbs. Cortex, 20, 207220.
Nickels, L. (2001). Therapy for naming disorders: Revisiting, revising, and reviewing. Aphasiology, 16, 935979.
Obler, L.K. & Albert, M. (1986). Action Naming Test. Unpublished test.
Pashek, G.V. (1997). A case study of gesturally cued naming in aphasia: Dominant versus nondominant hand training. Journal of Communication Disorders, 30, 349365.
Pashek, G.V. (1998). Gestural facilitation of noun and verb retrieval in aphasia: A case study. Brain & Language, 65, 177180.
Raymer, A.M. (2005). Naming and word-retrieval problems. In L.L. LaPointe (Ed.), Aphasia and related neurogenic language disorders (pp. 6882). New York: Thieme.
Raymer, A.M., Ciampitti, M., Holliway, B., Singletary, F., Blonder, L.X., Ketterson, T., Heilman, K.M., & Rothi, L.J.G. (in press.) Lexical-semantic treatment for noun and verb retrieval impairments in aphasia. Neuropsychological Rehabilitation.
Raymer, A.M. & Maher, L.M. (2001). Effects of verbal plus gestural training on limb apraxia: A case study. Journal of the International Psychological Society, 7, 248.
Raymer, A.M., Rueger, S., & Noga, A. (2004). Noun and verb comprehension and retrieval in normal aging. ASHA Leader, 9, 120.
Raymer, A.M. & Thompson, C.K. (1991). Effects of verbal plus gestural treatment in a patient with aphasia and severe apraxia of speech. In T.E. Prescott (Ed.), Clinical Aphasiology, Vol. 12 (pp. 285297). Austin, TX: Pro-Ed.
Richards, K., Singletary, F., Koehler, S., Crosson, B., & Rothi, L.J.G. (2002). Treatment of nonfluent aphasia through the pairing of a non-symbolic movement sequence and naming. Journal of Rehabilitation Research & Development, 39, 716.
Rodriguez, A., Raymer, A.M., & Rothi, L.J.G. (2006). Effects of gesture+verbal and semantic-phonologic treatments for verb retrieval in aphasia. Aphasiology, 20, 286297.
Rose, M. & Douglas, J. (2001). The differential facilitatory effects of gesture and visualization processes on object naming in aphasia. Aphasiology, 15, 977990.
Rose, M., Douglas, J., & Matyas, T. (2002). The comparative effectiveness of gesture and verbal treatments for specific phonologic naming impairment. Aphasiology, 16, 10011030.
Rothi, L.J.G. (1995). Behavioral compensation in the case of treatment of acquired language disorders resulting from brain damage. In R.A. Dixon & L. Mackman (Eds.), Compensating for psychological deficits and declines: Managing losses and promoting gains (pp. 219230). Mahwah, NJ: Lawrence Erlbaum.
Rothi, L.J.G., Raymer, A.M., & Heilman, K.M. (1997). Limb praxis assessment. In L.J.G. Rothi & K.M. Heilman (Eds.), Apraxia: The neuropsychology of action (pp. 6173). Hove, East Sussex, UK: Psychology Press.
Schwartz, R.L., Barrett, A.M., Crucian, G.P., & Heilman, K.M. (1998). Dissociation of gesture and object recognition. Neurology, 50, 11861188.
Shapiro, K.A., Mottaghy, F.M., Schiller, N.O., Poeppel, T.D., Flub, M.O., Muller, H.-W., Caramazza, A., & Krause, B.J. (2005). Dissociating neural correlates for nouns and verbs. NeuroImage, 24, 10581067.
Shapiro, K.A., Moo, L.R., & Caramazza, A. (2006). Cortical signatures of noun and verb production. PNAS, 103, 16441649.
Soros, P., Cornelissen, K., Laine, M., & Salmelin, R. (2003). Naming actions and objects: Cortical dynamics in healthy adults and in an anomic patient with a dissociation in action/object naming. Neuroimage, 19, 17871801.
Thompson, C.K., Bonakdarpour, B., Blumenfeld, H., Fix, S., Parrish, T., Gitelman, D., & Mesulam, M.-M. (2004). Neural correlates of word class processing: An fMRI study. Brain and Language, 91, 1516.
Tyler, L.K., Russell, R., Fadili, J., & Moss, H.E. (2001). The neural representation of nouns and verbs: PET studies. Brain, 124, 16191634.
Ungerleider, L.G. & Haxby, J.V. (1994). “What” and “where” in the human brain. Current Opinions in Neurobiology, 4, 157165.
Warburton, E., Wise, R.J.S., Price, C.J., Weiller, C., Hadar, U., Ramsay, S., & Frackowiak, R.S.J. (1996). Noun and verb retrieval by normal subjects: Studies with PET. Brain, 119, 159179.
Wilshire, C.E. & Coslett, H.B. (2000). Disorders of word retrieval in aphasia: Theories and potential applications. In S.E. Nadeau, L.J.G. Rothi, & B. Crosson (Eds.), Aphasia and language: Theory to practice (pp. 82107). New York: Guilford Press.
Zingeser, L.B. & Berndt, R.S. (1990). Retrieval of nouns and verbs in agrammatism and anomia. Brain and Language, 39, 1432.



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